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Obesity and overweight are major health concerns, with a 19.7% prevalence among Malaysian adults, as reported in the 2019 National Health and Morbidity Survey. This study assessed the effectiveness of an educational intervention on weight control intention using the Health Belief Model (HBM). A quasi-experimental design was employed, involving 140 participants equally divided into an intervention group (IG) and a control group (CG). Post-intervention, the IG showed significant improvement in perceived self-efficacy in dieting (mean score 3.96 ± 0.85) compared to the CG (3.76 ± 0.86, p = 0.003). Perceived self-efficacy in exercise also increased in the IG (4.12 ± 0.52) compared to the CG (3.51 ± 0.94, p < 0.001). While behavioral intention scores improved in the IG (4.00 ± 0.59), the difference was not significant (p = 0.300). This study highlights that educational interventions using HBM can effectively improve self-efficacy and influence weight control behaviors., (© 2024. The Author(s).)

Background: Knee osteoarthritis (OA) is a leading cause of disability among the elderly and is often exacerbated by obesity. Research supports weight loss and exercise therapy as key strategies for managing knee OA-related disability. Concurrently, telemedicine is becoming a popular healthcare approach. This study aimed to develop and evaluate an 8-week tele-education programme's impact on weight control and knee OA outcomes., Methods/design: Participants with knee OA and obesity were included. Baseline data on pain (VAS index), physical activity (GPAQ questionnaire), and quality of life (EQ5D and KOOS questionnaires) were collected. Performance tests, including the 30-second Chair Stand test (30CST) and the Timed Up-and-Go test (TUG), were recorded. Participants were randomly divided into two groups: a control group receiving oral advice on diet and exercise, and an intervention group receiving educational videos on nutrition, lifestyle changes, physical activity, individualised exercises, and psychosocial support. Evaluations were repeated after 8 weeks., Results: Data from 25 of 30 participants were analysed. In the intervention group, body composition, waist, and abdominal circumference decreased significantly (p < 0.05). The KOOS questionnaire showed significant improvements in pain, activity, and daily tasks (p = 0.00). The EQ5D questionnaire and health satisfaction also showed positive results within the intervention group (p = 0.00) and between groups (p = 0.008). The pain index improved significantly within (p = 0.00) and between groups (p = 0.02). Functional test results were significant within the intervention group (p = 0.00) and between groups (p = 0.017 for 30CST and p = 0.004 for TUG)., Conclusion: An 8-week tele-education programme for weight control and exercise therapy in knee OA patients significantly improved body composition, quality of life, and functional performance. Given the costs of obesity and knee OA on both people and the health system, tele-education can be a cost-effective treatment strategy., (© 2024 John Wiley & Sons Ltd.)

Obesity is an abnormal and potentially dangerous condition caused by excess body fat accumulation. The number of people with obesity is increasing worldwide. Obesity is the primary cause of various diseases; therefore, it is crucial to make efforts to control body weight. Identifying the factors that influence men with obesity to attempt to control and not control their weight is essential. The objective of this study was to create a prediction model for weight control experience among Korean men in their 30 s and 40 s. We analyzed data from the 2022 Community Health Survey and included 12,311 men who were overweight or obese. The men were divided into two groups based on their weight control experience: (1) Yes group (n = 9405) and (2) No group (n = 2906). Chi-square and independent t-tests were used to compare general and health-related characteristics between the groups. Decision tree analysis was used to build a prediction model for weight control experience. A split-sample test was conducted to validate the model. From the results of this study, various models predicting weight control experience were derived. From the decision tree model without setting the first node, those who weighed below average, had a high school diploma or less, and did not know their blood sugar levels had the highest probability of not controlling their weight at 55.3%. In the prediction model where the first node was set to age, those in their 40 s who thought their weight was below average and were unaware of their blood sugar levels had the highest rate of not trying to control their weight at 50.1%. In the prediction model where the first node was set to BMI, those who were overweight but thought their weight was below average and had a high school diploma or less had the highest rate of not trying to control their weight at 51.5%. There is an urgent need to provide obesity prevention and management education to those who have no weight control experience, particularly those at high risk, as identified in this study., (© 2024. The Author(s).)

Purpose: A combined body weight loss and upper body/arm exercise programme is a potential strategy for managing Breast cancer related lymphoedema (BCRL), but there is limited data on the best method for delivery or its potential efficacy., Methods: Fifty-seven women with overweight/obesity and BCRL were randomised to a 12 week supervised (n = 12) or home-based combined weight loss and upper body/arm exercise programme (n = 16), a home-based upper-body arm exercise only programme (n = 17) or standard care (n = 12). Primary outcomes were uptake, retention and changes in weight and change in Relative Arm Volume Increase (RAVI) using analysis of covariance (ANCOVA)., Results: Sixteen percent of women invited joined the study and 49 completed the trial (85% retention). Reductions in weight occurred in the supervised and home-based weight control and exercise programmes; Mean (95% CI) change compared to standard care - 1.68 (- 4.36 to - 1.00), - 2.47(- 4.99 to - 0.04) Kg. Reductions in perometer assessed RAVI were seen in the supervised and home-based combined weight control and arm exercise groups and the weight stable home-based arm exercise only group: mean (95% CI) change compared to standard care - 2.4 (- 5.0 to + 0.4),- 1.8 (- 4.3 to + 0.7), - 2.5(- 4.9 to - 0.05)%., Conclusion: Women with BCRL and overweight and obesity engaged in diet and exercise weight loss programmes. Both weight loss/arm exercise programmes led to modest changes in weight and BCRL. Comparable reductions in BCRL were reported in the weight stable group undertaking arm exercise only. The independent and combined effects of weight loss and exercise on BCRL need further study., Trial Registration: ISRCTN86789850 https://doi.org/10.1186/ISRCTN86789850 , registered 2011., (© 2024. The Author(s).)

Hypothalamic obesity does not respond well to conventional interventions for obesity. GLP-1 receptor agonists have mechanisms independent of the hypothalamus which may be potentially beneficial for managing hypothalamic obesity. This systematic review summarizes the efficacy and safety of GLP-1 receptor agonists use in hypothalamic obesity. A PRISMA-compliant systematic review was performed. Data was extracted from included studies and analysed based on change in weight, body mass index, glycaemic control, satiety, and safety profile with GLP-1 receptor agonist use. Ten studies comprising 5 case reports, 4 case series and 1 randomized-controlled trial included 54 patients (24 males, 30 females) with mean age of 25.2 (range 13-71) years with hypothalamic obesity who had received GLP-1 receptor agonists (exenatide = 48, liraglutide = 5 and dulaglutide = 1) over a mean duration of treatment of 12 (range 3-51) months. Mean weight reduction of 7.4 (SD 7.92) kg was observed in patients in whom weight was reported, with 85.7% of patients experiencing weight loss. All patients on liraglutide had weight reduction post-therapy. The sole trial had reported a non-significant reduction in BMI post-exenatide. Glycaemic control had either improved/maintained in all patients in whom this was measured. The main side effects of GLP-1 receptor agonist in individuals with hypothalamic obesity were nausea and vomiting; there were no major safety concerns. Based on limited published experience, GLP-1RA may be effective and safe for weight control in hypothalamic obesity, with the added benefit of improved glycaemic control in those with concurrent diabetes mellitus., (© 2024 World Obesity Federation.)

Different starch-to-protein ratios were compared among neutered and spayed domiciled cats. Male and female obese and non-obese cats were fed kibble diets ad libitum for 4 months high in starch (HS (38 % crude protein (CP)): starch 32 %, protein 38 %; DM basis) or high in protein (HP (55 % CP): starch 19 %, protein 55 %) but similar in energy and fat in a crossover design. Physical activity was evaluated using an accelerometer, and body composition (BC), energy expenditure (EE) and water turnover (WT) using the doubly labelled water method. Results were compared in a 2 diet × 2 sex × 2 body condition factorial arrangement. Cats fed the HS (38 % CP) diet maintained a constant body weight, but lean mass (LM) tended to be reduced in female obese but to be increased in male non-obese ( P < 0·08) and increased in female non-obese cats ( P = 0·01). The HP (55 % CP) diet induced an increase in cat body weight and LM ( P < 0·05) without altering BC proportion. EE tended to be higher in males (351 (se 8) kJ/kg 0·67 /d) than females (330 (se 8) kJ/kg 0·67 /d; P = 0·06), was unaffected by diet or BC, decreased as age increased ( R 2 0·44; P < 0·01) and increased as physical activity increased ( R 2 0·58; P < 0 · 01). WT was higher for the HP (55 % CP) diet ( P < 0 · 01) and increased with EE ( R 01). The HS (38 % CP) diet favoured body weight control during 4 months of 2 0·65; P < 0 · 01). The HS (38 % CP) diet favoured body weight control during 4 months of ad libitum feeding. Caution is necessary to balance protein in diets of female obese cats over 5 years, as they may have low energy and food intake, with LM loss.

Objective: To examine changes in leukocyte telomere length (LTL) during and after a behavioural weight control program for children with obesity., Methods: We measured LTL among a cohort of 158 children 8-12 years of age with a body mass index greater than or equal to the 95th percentile for age and sex. Children were 55% female, 29% white, 52% Latinx, 8% Asian and 11% Pacific Islander, other or multiethnic. All children participated in a 6-month, family-based, group behavioural weight control program and were assessed before treatment, after treatment and 1 year after the end of treatment. To test the sample population slope of LTL over the intervention and maintenance time periods, we fit spline mixed-effect regression models., Results: LTL increased an average of 0.09 T/S units per year (95% confidence interval [CI] 0.04 to 0.13; p = 0.0001) during the weight control program intervention period, followed by an average decline of -0.05 T/S units per year (95% CI -0.08 to -0.03; p < 0.0001) during the 1 year of follow-up after the completion of the intervention. Among 26 social, psychological, behavioural and physiological factors we examined, we did not find any predictors of these changes., Conclusions: LTL increased in response to a behavioural weight control program among children with obesity, suggesting an impact on biological health and cellular aging from participation in a behavioural weight control intervention. LTL may be a useful biomarker for assessing changes in response to behavioural interventions., (© 2023 World Obesity Federation.)

Background: Misperceptions about obesity is common among adolescents. Adolescents who overestimate their body size tend to indulge in extreme weight control behaviors. However, little is known about the factors involved in the adoption of extreme weight control behavior (EWCB) by non-obese adolescents who are mistaken for being overweight. This study identified factors associated with unhealthy behaviors among normal/underweight high school students who overestimate their body image and attempt to lose weight., Design: A secondary analysis of nationally representative data from the Korea Youth Risk Behavior Survey focused on adolescents who attended vocational and academically oriented high schools., Methods: The analysis included data from 4,286 non-obese respondents (15-18 years) who overestimated their body weight. Of them, 2,887 were girls (66.5%), while 1,399 were boys (33.5%). Multiple logistic regression was used to investigate risk factors for EWCB by sex. A statistical analysis reflecting strata, clusters, and weights of the complex sampling design was adopted., Results: Of the respondents, 674 (23.3%) girls and 162 (11.5%) boys reported EWCB. For both sexes, vocational high school attendance and depression were significantly influenced by EWCB. EWCB was linked to perceived stress in girls and living in a big city in boys., Conclusions: The findings suggest the importance of providing quality health education, including that for non-obese adolescents, in school obesity prevention programs along with the expansion of tailored intervention programs based on sex, following a consideration of the characteristics of high schools as well as individuals., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The rising incidence of health-endangering obesity constantly calls for more effective treatments. Gastric intramural injection of botulinum neurotoxin A (BTX-A) as a new modality carries great promise yet inconsistent therapeutic efficacy. A layer-specific delivery strategy enabled by dissolving microneedles is hence pioneered to investigate the working site of BTX-A and the resulting therapeutic effects. The drug-loaded tips of the layer-specific gastric paralysis microneedles (LGP-MN) rapidly release and achieve uniform distribution of BTX-A within the designated gastric wall layers. In an obesity rat model, the LGP-MNs not only prove safer than conventional injection, but also demonstrate consistently better therapeutic effects with muscular layer delivery, including 16.23% weight loss (3.06-fold enhancement from conventional injection), 55.20% slower gastric emptying rate, improved liver steatosis, lowered blood lipids, and healthier gut microbiota. Further hormonal study reveals that the elevated production of stomach-derived glucagon-like peptide-1 due to the muscularis-targeting LGP-MN treatment is an important contributor to its unique glucose tolerance-improving effect. This study provides clear indication of the gastric muscularis as the most favorable working site of BTX-A for weight loss and metabolic improvement purposes, and meanwhile suggests that the LGP-MNs could serve as a novel clinical approach to treat obesity and metabolic syndromes., (© 2023 The Authors. Advanced Science published by Wiley-VCH GmbH.)

Objective: Exercise is a transdiagnostic clinical feature of eating disorders, but consensus is lacking as to what constitutes, and gives rise to, excessive exercise motivated by weight control. Using a longitudinal cohort study, we aimed to describe population-level prevalence rates of varying levels of weight-control exercise and examine gender and weight status (overweight or obesity; OVOB) as cross-sectional determinants of weight-control exercise in 14-15-year-old adolescents. We then evaluated the association of OVOB at 10-11 years with weight-control exercise at 14-15 years., Methods: The sample comprised 6329 adolescents from the Longitudinal Study of Australian Children (LSAC). Weight and height were measured in early adolescence (aged 10-11) and in mid-adolescence (aged 14-15). Participants reported weight-control exercise using the Branched Eating Disorders Test at 14-15 years., Results: In mid-adolescence, the estimated population prevalence for any weight-control exercise was 49 % (55 % in females). For girls, moderate levels of exercise were most prevalent, and low levels for boys. For all levels except for the very lowest, boys with (vs. without) OVOB history (10-11 years) had about twice the odds of endorsing every level of weight-control exercise. Patterns among girls were similar, though lower in magnitude (∼1.5 times)., Conclusions: For both girls and boys, across most exercise levels, rates of weight-control exercise were greatest for those with OVOB; for the highest exercise level, effects were strongest for boys with OVOB. To accurately identify at-risk adolescents, our results provide preliminary support for a fluid definition of excessive weight-control exercise, dependent on gender and weight status., Competing Interests: Conflict of interest Dr. Le Grange receives royalties from Guilford Press and Routledge, is co-director of the Training Institute for Child and Adolescent Eating Disorders, LLC., and a member of Equip Health Clinical Advisory Board. All authors report no other potential conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Traditional health management requires many human and material resources and cannot meet the growing needs. Remote medical technology provides an opportunity for health management; however, the research on it is insufficient., Objective: The objective of this study was to assess the effects of remote interventions on weight management., Methods: In this randomized controlled study, 750 participants were randomly assigned to a remote dietary and physical activity intervention group (group DPI), remote physical activity intervention group (group PI), or control group (group C). At baseline (time 1), day 45 (time 2), and day 90 (time 3), data were collected, including data on dietary intake, physical activity, indexes related to weight control, and health benefits., Results: A total of 85.6% (642/750) of participants completed the follow-up. Compared with group C, group DPI showed a significant decrease in energy intake (-581 vs -82 kcal; P<.05), protein intake (-17 vs -3 g; P<.05), fat intake (-8 vs 3 g; P<.05), and carbohydrate intake (-106.5 vs -4.7 g; P<.05) at time 3. Compared with time 1, groups DPI and PI showed a significant decrease in cereal and potato intake (P<.05). Compared with time 1, the physical activity levels related to transportation (group PI: 693 vs 597 metabolic equivalent [MET]-min/week, group C: 693 vs 594 MET-min/week; P<.05) and housework and gardening (group PI: 11 vs 0 MET-min/week, group C: 11 vs 4 MET-min/week; P<.05) in groups PI and C were improved at time 3. Compared with groups PI and C, group DPI showed a significant decrease in weight (-1.56 vs -0.86 kg and -1.56 vs -0.66 kg, respectively; P<.05) and BMI (-0.61 vs -0.33 kg/m 2 and -0.61 vs -0.27 kg/m 2 , respectively; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in body weight (-4.11 vs -1.01 kg and -4.11 vs -0.83 kg, respectively; P<.05) and BMI (-1.61 vs -0.40 kg/m 2 and -1.61 vs -0.33 kg/m 2 , respectively; P<.05) at time 3. Compared with group C, group DPI showed a significant decrease in triglyceride (-0.06 vs 0.32 mmol/L; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in systolic blood pressure (-8.15 vs -3.04 mmHg and -8.15 vs -3.80 mmHg, respectively; P<.05), triglyceride (-0.48 vs 0.11 mmol/L and -0.48 vs 0.18 mmol/L, respectively; P<.05), and fasting blood glucose (-0.77 vs 0.43 mmol/L and -0.77 vs 0.14 mmol/L, respectively; P<.05). There were significant differences in high-density lipoprotein cholesterol (-0.00 vs -0.07 mmol/L; P<.05) and hemoglobin A 1c (-0.19% vs -0.07%; P<.05) between groups DPI and C., Conclusions: Remote dietary and physical activity interventions can improve dietary intake among participants with overweight and obesity, are beneficial for weight control, and have potential health benefits., Trial Registration: Chinese Clinical Trial Registry ChiCTR1900023355; https://www.chictr.org.cn/showproj.html?proj=38976., (©Na Zhang, Mingzhu Zhou, Muxia Li, Guansheng Ma. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 28.04.2023.)

Dietary intake of medium-chain triacylglycerols (MCTs) is known to alleviate obesity. MCTs have also been suggested to beneficially influence protein metabolism. This study evaluated the effects of dietary intake of MCTs on energy restriction-induced weight control and loss of skeletal muscle. Rats were divided into the following groups: 1) AL-LCT group that received the AIN-93G-based control diet containing long-chain triacylglycerols (LCTs) ad libitum, 2) ER-LCT group fed the control diet with 30% energy restriction, and 3) ER-MCT group fed a diet containing MCTs with 30% energy restriction. After the 4-wk dietary treatment, both energy-restricted groups had significantly lower body weight than the AL-LCT group and rats in the ER-MCT group were significantly lighter than those in the ER-LCT group. In contrast, the extent of energy restriction-induced loss of skeletal muscle was not significantly different between the two energy-restricted groups, resulting in an increase in muscle mass relative to body weight in the ER-MCT group. Despite maintaining the lower body weight, dietary intake of MCTs did not further influence signaling pathways involved in protein synthesis or breakdown. These results suggest that intake of MCTs could be a valuable dietary intervention to maintain a lower body weight and increase relative muscle mass without negative effects on skeletal muscle protein metabolism.

Abstract Obesity is an abnormal and potentially dangerous condition caused by excess body fat accumulation. The number of people with obesity is increasing worldwide. Obesity is the primary cause of various diseases; therefore, it is crucial to make efforts to control body weight. Identifying the factors that influence men with obesity to attempt to control and not control their weight is essential. The objective of this study was to create a prediction model for weight control experience among Korean men in their 30 s and 40 s. We analyzed data from the 2022 Community Health Survey and included 12,311 men who were overweight or obese. The men were divided into two groups based on their weight control experience: (1) Yes group (n = 9405) and (2) No group (n = 2906). Chi-square and independent t-tests were used to compare general and health-related characteristics between the groups. Decision tree analysis was used to build a prediction model for weight control experience. A split-sample test was conducted to validate the model. From the results of this study, various models predicting weight control experience were derived. From the decision tree model without setting the first node, those who weighed below average, had a high school diploma or less, and did not know their blood sugar levels had the highest probability of not controlling their weight at 55.3%. In the prediction model where the first node was set to age, those in their 40 s who thought their weight was below average and were unaware of their blood sugar levels had the highest rate of not trying to control their weight at 50.1%. In the prediction model where the first node was set to BMI, those who were overweight but thought their weight was below average and had a high school diploma or less had the highest rate of not trying to control their weight at 51.5%. There is an urgent need to provide obesity prevention and management education to those who have no weight control experience, particularly those at high risk, as identified in this study.

Background: Personalizing approaches to prevention and treatment of obesity will be a crucial aspect of precision health initiatives. However, in considering individual susceptibility to obesity, much remains to be learned about how to support healthy weight management in different population subgroups, environments and geographical locations., Subjects/methods: The International Weight Control Registry (IWCR) has been launched to facilitate a deeper and broader understanding of the spectrum of factors contributing to success and challenges in weight loss and weight loss maintenance in individuals and across population groups. The IWCR registry aims to recruit, enroll and follow a diverse cohort of adults with varying rates of success in weight management. Data collection methods include questionnaires of demographic variables, weight history, and behavioral, cultural, economic, psychological, and environmental domains. A subset of participants will provide objective measures of physical activity, weight, and body composition along with detailed reports of dietary intake. Lastly, participants will be able to provide qualitative information in an unstructured format on additional topics they feel are relevant, and environmental data will be obtained from public sources based on participant zip code., Conclusions: The IWCR will be a resource for researchers to inform improvements in interventions for weight loss and weight loss maintenance in different countries, and to examine environmental and policy-level factors that affect weight management in different population groups. This large scale, multi-level approach aims to inform efforts to reduce the prevalence of obesity worldwide and its associated comorbidities and economic impacts., Trial Registration: NCT04907396 (clinicaltrials.gov) sponsor SB Roberts; Tufts University IRB #13075., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

This study examined mediating effects of body weight control behaviors in the relationship between body weight perception and health-related behaviors among 11,458 U.S. adolescents from the 2010 National Youth Physical Activity and Nutrition Survey. Parallel multiple mediation analysis was performed for the secondary data analysis. Nearly one third of adolescents (32.5%) had overweight or obesity; one quarter (25.0%) perceived themselves as slightly overweight and 5.1% thought they were very overweight. More girls (58.6%) had tried to lose weight than boys (32.3%), while boys were more physically active than girls. Healthy and unhealthy weight control behaviors significantly mediated the relationship between adolescents' body weight perception and health-related behaviors (physical activity and screen time). Teachers and parents should help adolescents have accurate weight perception and utilize reliable and healthy weight control strategies. Future studies should consider the intercorrelated relationships among adolescents' perceptions and behaviors regarding weight to provide successful weight control intervention programs.

Obesity is one of the most glaringly obvious, yet most neglected, public health problems the world is facing today. Individuals' self-perception of being overweight is essential to engaging in weight control behavior. This is the first exploratory study in Chongqing to assess the mediating effect of perceived obesity in close relatives on obesity and weight control behavior among adults. A cross-sectional study, including 3,7492 participants, was conducted in a healthcare center in Chongqing, China. For Kruskal-Wallis test analyses, logistic regression and Sobel-Goodman mediation tests were employed. Only 1.76% of participants (660) were medically identified as obese, and only 2.13% of participants (798) thought their close relatives were obese. Nearly one-third of the participants consumed more than double the daily recommended amount of meat. More than 85% of participants were physically inactive. Obesity was positively associated with obesity perception in close relatives (OR = 19.556, P < 0.001). The association between the respondent's obesity status and weight control behavior scores changed statistically significantly (β = 0.594, P < 0.001). Individuals who perceived their close relatives as obese were more likely to engage in weight control behavior themselves (β = 0.678, P = 0.001). The obesity perception in close relatives partially mediated the association between obesity and weight control behavior (ab = 0.141, SE = 0.03, 95% CI = 0.086, 0.198). Obese people are more likely to engage in weight control behaviors. The effect of individuals' obesity status on weight control behavior scores is partially mediated by the obesity perception in close relatives among the participants. Findings suggest that personal obesity status perceptions of close relatives might provide new weight management ideas for healthcare centers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wu, Liu, Chen, Guo and Sun.)

Lifestyle and physical characteristics affect body weight, and understanding these factors improves the precision of weight loss treatment. Many obese patients in Korea are receiving Korean medicine (KM) treatment, including herbal medicine and acupuncture, for weight loss. However, the real-world data (RWD) are insufficient in terms of being longitudinal and diverse. Weight Control Registry using KM is a prospective registry study that enrolls patients receiving KM treatment for weight loss and collects RWD from multiple clinics. The patients who are eligible for this study are aged 19-65 years, receive KM weight loss treatment, understand the study objectives, and consent voluntarily. Clinical data of patient characteristics and KM treatment patterns will be regularly collected until 2026. The longitudinal accumulation of various RWD will establish a high-quality study database for KM weight loss treatment. With this study, we expect to contribute to understanding the current trend of weight loss treatment with KM and solve further questions regarding this treatment.

Although obesity level is considered to influence weight-control behavior, few studies have examined how predictors of weight-control behavior differ according to obesity level. We compared the predictors of weight-control behavior in healthy weight and overweight middle-aged Korean women. This study used a comparative cross-sectional design. In total, 352 middle-aged women (131 overweight and 221 healthy) who visited community centers in eight Korean cities participated in the study. Participants completed self-report questionnaires concerning perceived health, body dissatisfaction, health-related concerns, self-esteem, and weight-control behavior. Scores for weight-control behavior in the overweight group were higher than those in the healthy weight group. Stepwise multiple regression showed that health-related concerns, body dissatisfaction, socioeconomic status, and self-esteem predicted weight-control behavior in the overweight group. Perceived health, socioeconomic status, meal regularity, health-related concerns, and age predicted weight-control behavior in the healthy weight group. The findings indicate that nursing strategies should differ according to obesity level to improve weight-control behavior in middle-aged women. In community or clinical settings, nurses are advised to develop customized weight control programs based on obesity levels in middle-aged women.

Introduction: Obesity in young adulthood increases the risk for premature death, and the prevalence of obesity rapidly increasing among young adults, particularly in young men. We evaluated the gender differences in accompanying comorbidities and attitudes regarding weight control among young Korean adults with obesity., Materials and Methods: We analyzed 2,050 young adults with obesity (1,325 men and 725 women) in the 7th KNHANES (2016-2018) aged 19-44 years, with body mass indexes (BMIs) ≥25.0 kg/m2. The odds ratios (ORs) and 95% confidence intervals (CIs) for poor lifestyle factors and accompanying illnesses as well as self-perceived weight status, weight control efforts, and weight control strategies in men compared to those in women were calculated by multivariate logistic regression analysis., Results: The mean BMIs and waist circumferences were 28.2 ± 0.1 kg/m2 and 93.6 ± 0.2 cm and 28.6 ± 0.1 kg/m2 and 88.7 ± 0.4 cm, in men and women, respectively. The ORs and 95% CIs for abdominal obesity (1.52, 1.11-2.07), hypertension (3.11, 2.20-4.40), hypercholesterolemia (1.45, 1.09-1.93), hypertriglyceridemia (3.37, 2.38-4.78), and elevated alanine transaminase concentration (6.53, 4.56-9.36) were higher in young men compared to those in young women. Despite the higher prevalences of comorbid conditions, the odds of inappropriate weight perception (8.13, 4.17-15.86), lack of weight control efforts (2.20, 1.71-2.84), lack of diet therapy (1.56, 1.13-2.16), lack of pharmacotherapy (13.27, 6.82-25.79), heavy drinking (1.32, 1.02-1.72), current smoking (6.92, 5.00-9.59), and frequent eating out (4.38, 3.35-5.71) were higher among men. However, the odds of not engaging in exercise (0.48, 0.35-0.64) were lower among men compared to that in women., Discussion: Despite their higher prevalences of comorbidities, appropriate weight perception and weight control efforts are insufficient in young men with obesity. These gender differences should be considered to provide tailored programs for weight reduction in young adults with obesity., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

Abstract Background Previous research has established the importance of moderate‐to‐vigorous physical activity (MVPA) for weight control. One area of unexplored investigation is the relationship between individuals' perceptions of the importance of MVPA for weight control and MVPA engagement. This study examined the associations between the perceived importance of MVPA and MVPA engagement, weight loss, barriers to PA, and exercise enjoyment in adults enrolled in a long‐term behavioral weight loss (BWL) intervention. Methods Adults (N = 301) with overweight/obesity (BMI = 27–45 kg/m2) completed an 18‐month BWL intervention, followed by a no‐intervention 18‐month follow‐up. At baseline, 6 months, 18 months (i.e., post‐treatment), and 36 months (i.e., follow‐up), participants ranked the importance of six strategies for weight control: keeping a food record, MVPA, light PA, self‐weighing, small portions, and low‐calorie diet. Observed MVPA (measured by accelerometer), percent weight loss, perceived barriers to PA, and exercise enjoyment were also measured at each assessment. Results Results showed that most participants perceived MVPA as a primary weight control strategy (first, second, or third most important) throughout the intervention, regardless of the weight control goal (weight loss vs. maintenance). Individuals who ranked MVPA as a primary strategy for weight control at concurrent time points, compared to those who did not, engaged in significantly more MVPA at post‐treatment, had greater weight loss at follow‐up, endorsed fewer barriers to PA at post‐treatment and follow‐up, and reported greater exercise enjoyment at baseline and post‐treatment. Conclusion Perceived importance of MVPA was related to subjective experiences of MVPA, MVPA adherence, and weight loss in a long‐term BWL intervention.

The study examined the effect of a weight control intervention on BMI, physical activity levels, and psychological variables toward physical activity. Thirty-three middle-aged obese women participated in the 16-week weight control intervention. Results indicated that the participants' BMI significantly decreased and physical activity levels significantly increased over the intervention. Moreover, exercise self-efficacy and perceived benefits toward physical activity significantly increased, but perceived barriers of physical activity gradually decreased over the intervention. The study suggests that it is important to consider not only physical activity itself, but also the various psychological variables when planning and implementing the weight control program.

Overweight and obesity remain serious public health concerns. Outcomes from community based commercial weight management programmes vary, relapse is common and drop out is high. Outcomes could be improved by better understanding experiences on these programmes. The aim of our study was to generate accounts of people's experience on a commercial weight-management program to identify what experiences were perceived as facilitating, and what posed risks, to programme effectiveness and compliance. We conducted individual, semi-structured interviews with eighteen Caucasian women (mean age 45.4y) who were members of nation-wide UK commercial, fee-paying, community weight management programme. Interview data was analysed via framework analysis. Participants' experiences indicated that the programme helped by triggering several intra- and interpersonal processes that catalysed change across psychological, physiological, dietary and behavioural areas of their life. Risks to program adherence and effectiveness spanned well-known risks such as self-regulation fatigue and the difficulty of recovering from negative self-criticism, as well as new factors such as the confusing nature of weight change, the relatively powerful impact of everyday events, and the difficulty in getting the balance right between personalised support vs. intrusion. The complexity of reported experiences challenges the linear, predictive pathways of change proposed by many health behaviour models of weight management. To improve effectiveness, programmes need to go well beyond behavioural and dietary support. It is recommended that community, commercial programmes educate people about the physiological and psychological tensions they will encounter, why people lose weight at different rates, the likelihood of weight relapse and strategies to manage these, including evidence-based support for managing self-criticism., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Obesity is an increasing global health problem and is associated with various diseases including stroke, respiratory diseases, diabetes mellitus, and hypertension. Various weight control strategies such as exercise, calorie-restricted diet, anti-obesity medication, herbal medicine, and functional food are being used. The present study aimed to investigate the trends of weight control strategies in Korean adults METHODS: This was a cross-sectional study that used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2017. A total of 64,207 participants were analyzed. The body mass index (BMI), subjective judgment of body appearance, practice of weight control, and methods to control weight were analyzed according to year and sex., Results: The prevalence rate of obesity in men based on a BMI of 25 or higher was slightly increased from 37.0% in 2007 to 41.1% in 2017. Among the weight control strategies, use of exercise decreased from 83.8% to 80.5% in men, and from 73.4% to 69.5% in women, reduction in the amount of food consumed increased from 47.1% to 60.5% in men and from 65.1% to 70.6% in women, consumption of functional food increased from 3% to 6.2% in men and from 3.2% to 8.7% in women, and rate of skipping meals increased from 6.1% to 12.0% in men and from 11.5% to 14.0% in women., Conclusion: The present study showed that exercise has decreased and dietary control and functional food consumption have increased as weight control strategies in Korean adults during the past decade., Competing Interests: Declaration of interest none, (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Unhealthy weight control behaviors are a serious concern, impairing the quality of life in adolescents. Although recent epidemiological studies indicate a high level of disordered eating in developing countries, such data in Ethiopia are scarce. Thus, this study aimed to determine the extent of unhealthy weight control behaviors (i.e., purging and nonpurging) and corresponding associated factors among urban Ethiopian adolescents., Method: A cross-sectional study using self-administered questionnaires was applied to 690 randomly selected female high school adolescents in Addis Ababa, Ethiopia in 2017. Measures included unhealthy weight control behaviors, body mass index, subjective perception of body weight, appearance satisfaction, depressive symptoms, and socio-demographic factors. Logistic regression was applied for data analyses, that is, adjusted odds ratio (aOR) with 95% confidence interval (CI)., Results: The level of unhealthy weight control behaviors (i.e., a score of at least once a week in the last 1 month) was 30.7% (N = 208). Specifically, the extent of purging and nonpurging weight control behaviors was 1.5% (N = 10) and 29.8% (N = 202), respectively. Factors that were significantly associated with unhealthy weight control behaviors were perception of being overweight [aOR = 3.01; 95%CI: 1.11-8.11], being overweight [aOR = 3.28; 95%CI: 1.54-7.01], severe depression [aOR = 4.09; 95%CI: 1.73-9.96], and high socio-economic status [aOR = 2.07; 95%CI: 1.30-2.80]., Conclusion: This study reveals a considerable level of unhealthy weight control behaviors among female adolescents in an urban setting in Ethiopia. Researchers and policy makers should focus their attention upon this emerging public health challenge and develop associated strategies., (© 2020 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc.)

Childhood-onset craniopharyngiomas, though rare, are intracranial malformations that can cause obesity by disrupting the hypothalamus, a condition that often persists even after tumor resection. This severe obesity increases the risk of diabetes and fatty liver disease in childhood. Concurrently, panhypopituitarism, including growth hormone (GH) deficiency, may develop. Notably, some individuals with GH deficiency may exhibit a normal growth rate, making GH therapy unnecessary for growth purposes. However, in these cases, GH therapy may still be beneficial in preventing the progression of nonalcoholic fatty liver disease or nonalcoholic steatohepatitis. Although weight management is traditionally considered the gold standard for preventing liver cirrhosis, its effectiveness can be limited by hypothalamic dysfunction and the difficulty of achieving successful weight control. Our case study highlights a patient with normal growth despite GH deficiency, who did not receive GH replacement therapy and continued to struggle with hypothalamic obesity. Despite effective body weight control, the patient developed hepatopulmonary syndrome, indicating that relying solely on weight management may not be sufficient to prevent liver complications. This case underscores the importance of addressing GH deficiency even when growth is normal. Our findings suggest that GH replacement therapy could be beneficial for preventing liver cirrhosis in such cases.

Background: A WW (formerly Weight Watchers) program adapted for persons with type 2 diabetes mellitus (T2DM) previously was found to be more effective than standard care (SC) intervention for weight loss, improved glycemic control, and weight- and diabetes-related quality of life measures. With data from the same national trial, this study examined whether WW adapted for persons with T2DM also increased engagement in weight control behaviors and decreased hedonic hunger, each of which could contribute to improved diabetes management., Intervention and Methods: Individuals with T2DM (n = 563) and overweight or obesity participated in a 12-month, 16-site, randomized trial of WW with diabetes counseling or SC. Hierarchical linear modeling (HLM) evaluated whether 12-month changes in weight control behaviors (Eating Behavior Inventory; EBI) and hedonic hunger (Power of Food Scale; PFS) differed by treatment condition. If a significant treatment effect was found, 12-month changes in EBI/PFS were regressed on 12-month changes in HbA 1c and percent weight loss to explore potential treatment differences in these associations., Results: EBI scores increased significantly over the 12-months (p < 0.001), with greater improvements in WW than SC (p < 0.001). PFS decreased significantly in the 12-months (p < 0.001), with no differences between treatment groups (p = 0.15). HLM analyses that followed up on the significant treatment effect for 12-month change in EBI revealed no significant differences by treatment condition for the relationship between change in EBI scores and change in HbA 1c (p = 0.14) or percent weight loss (p = 0.32). Across all participants, 12-month improvements in EBI and PFS were related to improved HbA 1c (r = 0.22; -0.13, respectively) and greater percent weight loss (r = 0.41; -0.18, respectively) (ps < 0.01)., Conclusions: WW with diabetes counseling produced greater engagement in weight control behaviors in those with T2DM than did SC. Across both groups, improved weight control behaviors and hedonic hunger were related to improved glycemic control and weight loss.

Aims/introduction: Obesity and metabolic syndrome are well-known to be associated with multiple chronic diseases. Currently, high-dose liraglutide has been used for weight control in non-diabetic patients. Considering incretin-based therapy is more effective in Asian populations, the effect of low-dose liraglutide in weight control among these non-diabetic groups has not been well evaluated. Our study aimed to evaluate the efficacy of low-dose liraglutide in weight control among Taiwan patients., Materials and Methods: From July 2017 to December 2018, 46 non-diabetic patients with metabolic syndrome were included. They had received low-dose liraglutide at 0.6 or 1.2 mg per day for weight reduction for 12 weeks. After then, changes in bodyweight, waist and metabolic factors were examined. Overt bodyweight reduction was defined as a decrease of >5% within 12 weeks., Results: With 12 weeks of medication use, both groups showed statistical weight reduction. Higher doses of liraglutide had better efficacy, and 44.4% of patients in the liraglutide 1.2 mg group reached overt weight reduction, whereas just 32.1% in the 0.6 mg group had achieved this. Young age was found to be a predictor factor for a positive finding (odds ratio 0.941, P = 0.037). Early responders with decreased bodyweight of >4.2% within the first 4 weeks indicated a better chance to achieve measurable weight reduction., Conclusions: Low-dose liraglutide still has high efficacy in weight reduction in Taiwanese people, especially for those of younger age., (© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

Background & Aims: Obesity and type 2 diabetes increase hepatocellular carcinoma (HCC) incidence in humans and accelerate diethylnitrosamine (DEN)-induced hepatocarcinogenesis in mice. We investigated whether exercise reduces HCC development in obese/diabetic Alms1 mutant (foz/foz) mice and studied protective mechanisms., Methods: We measured HCC development in DEN-injected male foz/foz and wild-type (WT) littermates housed with or without an exercise wheel from week 4 until 12 or 24 weeks, and in foz/foz mice pair-fed to WT littermates. We also studied HCC development in DEN-injected Jnk1 -/- .foz/foz mice generated by cross breeding, as well as their genetic controls. Dysplastic hepatocytes were identified by glutathione-S-transferase pi form (GST-pi) immunohistochemistry, liver nodules were counted, and HCC was analysed by histopathology., Results: Exercising foz/foz mice maintained similar weight as WT mice up to 10 weeks, but then gained weight and were obese by 24 weeks; a similar body weight profile was obtained by pair-feeding foz/foz mice to WT. At 12 weeks, livers of exercising foz/foz mice exhibited fewer GST-pi positive hepatocytes than sedentary counterparts; by 24 weeks, fewer exercising foz/foz mice developed HCC (15% vs. 64%, p <0.05). Conversely, pair-feeding foz/foz mice failed to reduce HCC incidence. In these insulin-resistant foz/foz mice, exercise failed to activate hepatic AMPK or Akt/mTORC1. Instead, it improved insulin sensitivity, ameliorated steatosis and liver injury, activated p53 to increase p27 expression, and prevented JNK activation. This was associated with suppression of hepatocellular proliferation. DEN-injected Jnk1 -/- .foz/foz mice failed to develop liver tumours or HCC at 24 weeks., Conclusions: Direct effects of exercise dampen proliferation of dysplastic hepatocytes to reduce 3-month dysplastic foci and 6-month incidence of DEN-induced HCC in obese, insulin-resistant mice. The effects of exercise that potentially slow hepatocarcinogenesis include p53-mediated induction of p27 and prevention of JNK activation., Lay Summary: Fatty liver disease commonly occurs alongside obesity and diabetes, contributing to rapidly increasing rates of liver cancer throughout the world. Herein, we show that exercise reduces the incidence and progression of hepatocellular carcinoma in mouse models. The effect of exercise on cancer risk was shown to be independent of changes in weight. Exercise could be a protective mechanism against liver cancer in at-risk individuals., Competing Interests: Conflict of interests The authors have no conflict of interest to disclose. Please refer to the accompanying ICMJE disclosure forms for further details., (Copyright © 2020 European Association for the Study of the Liver. All rights reserved.)

Background: Hypothalamic obesity causes unrelenting weight gain for childhood brain tumor survivors. No single therapy has proven effective for treatment. We aimed to evaluate effectiveness of long-term methylphenidate therapy on body mass index (BMI) change in children with hypothalamic obesity., Methods: A retrospective analysis included children with a history of brain tumor and hypothalamic obesity receiving methylphenidate (10-60 mg/day) for hypothalamic obesity. Subjects were evaluated for BMI trajectory before and after methylphenidate start. Given that z-scores can be skewed in severely obese children, we calculated BMI as a percent of the BMI at the 95th percentile for the child's age and gender (BMI% 95th)., Results: Twelve patients with hypothalamic obesity completed methylphenidate therapy for at least 6 months (median 3.1 years, range 1.0-5.8 years). All subjects had a suprasellar tumor (nine [75%] with craniopharyngioma) and pituitary dysfunction. Pretreatment median BMI percent of the 95th percentile was 125.6% (interquartile range [IQR] 25-75: 115.3-138.3%) with BMI z-score of 2.4 (IQR 25-75: 2.1-2.6). Following methylphenidate treatment, there was a 69.9% reduction in the median slope of BMI change. Eleven of 12 patients (92%) had a reduction in the slope of their BMI change on methylphenidate treatment. Postmethylphenidate median BMI percent of the 95th percentile decrease to 115.2% (IQR 25-75: 103.6-121.2%) with median BMI z-score of 2.1 (IQR 25-75: 1.8-2.2). Mild side effects were noted in six patients., Conclusions: Methylphenidate use reduced and sustained BMI change in children with hypothalamic obesity. Stimulant therapy is an effective first-line agent for treatment of hypothalamic obesity., (© 2020 Wiley Periodicals, Inc.)

Objective: To identify what is important to middle-aged Latino men and their personal goals and values as foundations for a future precision lifestyle medicine intervention that is rooted in Self-Determination Theory., Design: We used a phenomenological, thematic approach to analyze data from 20 semi-structured, individual interviews with Latino men aged 35-60 years., Setting: Community-based settings between November 2017 and May 2018 in South Florida., Participants: Latino or Hispanic men who were aged 35-60 years. The mean age of the men was 49.8 years., Results: Two key themes emerged: a) the characteristics that these men say define what it means to be a man; and b) the characteristics that these men say define what is important to them. "What defines a man" includes three primary subthemes: a) the attributes, characteristics and behaviors that participants understood to be ideals that a man should embody and the roles he should fulfill; b) lessons learned growing up about what it means to be a man; and c) how Latino men relate to the ideal of machismo. "What defines me" includes the subthemes: a) comparing themselves with the ideal of machismo; b) caring for family and others; and c) supporting and modeling positive behavior for their children., Conclusions: We found key candidate mechanisms that may be novel yet critical foundations on which to build a precision lifestyle medicine intervention for Latino men. We identified actionable psychosocial factors that map onto motivational constructs that can shape behaviors that are essential for weight control and be a useful foundation for improving the health of middle-aged Latino men., Competing Interests: Competing Interests: None declared., (Copyright © 2020, Ethnicity & Disease, Inc.)

Obesity is a global health problem affecting the general population. Acupoint catgut embedding (ACE) is an alternative treatment that involves the implantation of absorbable catgut suture at acupoints. The transient receptor vanilloid member 1 (TRPV1) is a calcium ion channel that responds to several chemical ligands and is identified in numerous locations throughout the body. The aim of the present study was to examine the effect of ACE treatment on obesity and its associated complications through various neural mechanisms in a murine model. A C57/BL6 wild type (WT) and TRPV1‑/‑ (KO) mouse model was utilized to exclude any psychological factors associated with obesity. The WT‑HFD‑ACE and WT‑HFD‑SHAM groups received weekly ACE or placebo treatments at the bilateral ST36 acupoint. The mice were fed with a normal mice chow diet (ND) or a high‑fat food diet (HFD; 45 kcal%), and their body weights were recorded once a week. After 8 weeks, the subjects were sacrificed and changes in the levels of a number of biomarkers were investigated using ELISA, immunoblotting and immunofluorescence. The results indicated a significant decrease in body weight variation for the WT‑HFD‑ACE group compared with the WT‑HFD and WT‑HFD‑SHAM groups, using the WT‑ND group as the body weight baseline. By contrast, KO mice fed with ND or HFD demonstrated notable body weight maintenance throughout the experimental period. Similar patterns were observed in adipose tissue mass, glucose, leptin and insulin plasma levels, and protein molecule density of TRPV1 and its associated molecules in the hypothalamus and nucleus tractus solitarii. In contrast, in the prefrontal cortex, significant decreases in the concentrations of MAPK pathway proteins in the WT‑HFD and WT‑HFD‑SHAM groups were observed. The levels of these proteins were significantly increased in the WT‑HFD‑ACE and KO‑HFD groups. These results suggested that TRPV1 and its associated pathways may be involved in body weight maintenance, and may be controlled through ACE treatment or genetic manipulation.

There is increasing scientific and public support for the notion that some foods may be addictive, and that poor weight control and obesity may, for some people, stem from having a food addiction. However, it remains unclear how a food addiction model (FAM) explanation for obesity and weight control will affect weight stigma. In two experiments ( N = 530 and N = 690), we tested the effect of a food addiction explanation for obesity and weight control on weight stigma. In Experiment 1, participants who received a FAM explanation for weight control and obesity reported lower weight stigma scores (e.g., less dislike of 'fat people', and lower personal willpower blame) than those receiving an explanation emphasizing diet and exercise ( F (4 , 525) = 7.675, p = 0.006; and F = 0.006), but not for personal willpower weight stigma ( (4,525) = 5.393, p = 0.81). Participants receiving the diet and exercise explanation had greater dislike of 'fat people' than those in the FAM explanation and control group ( F values < 0.05), with no difference between the FAM and control groups ( ( >0.05). The FAM explanation for weight control and obesity did not increase weight stigma and resulted in lower stigma than the diet and exercise explanation that attributes obesity to personal control. The results highlight the importance of health messaging about the causes of obesity and the need for communications that do not exacerbate weight stigma.5 , 684) = 5.157, p = 0.006), but not for personal willpower weight stigma ( F ( 5 , 684) = 0.217, p = 0.81). Participants receiving the diet and exercise explanation had greater dislike of 'fat people' than those in the FAM explanation and control group ( p values < 0.05), with no difference between the FAM and control groups ( p >0.05). The FAM explanation for weight control and obesity did not increase weight stigma and resulted in lower stigma than the diet and exercise explanation that attributes obesity to personal control. The results highlight the importance of health messaging about the causes of obesity and the need for communications that do not exacerbate weight stigma., Competing Interests: The authors declare no conflict of interest.

Background/objective: There are many methods for weight loss and they vary among people. Some are yet to be proven as appropriate regarding its physical or mental side effect. The aim of this study was to investigate the relationship between weight control success and depression by weight control behaviors (WCB) dividing them into appropriate and inappropriate., Subjects/methods: We used data from the 2016 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 4506 people were included in the study. The depression was measured by the 9-item Patient Health Questionnaire as a dependent variable. Using multiple regression analysis to determine the association between weight control success and depression with appropriate and inappropriate WCB, in men and women, separately., Results: We found that appropriate WCB was associated with decreased depression in women who had both success and fail (success: β=-0.16, S.E=0.50, p<.001; fail: β=-0.09, S.E=0.04, p=0.04), whereas inappropriate WCB increased depression in men regardless of success or failure at weight control (success: β=0.41, p=0.02; fail: β=0.22, p=0.02). Thus, women who are successful at weight control and use appropriate WCB are more likely to have a decrease in depressive symptoms. However, men are most affected by using inappropriate WCB and can have an increase in depressive symptoms as a result., Conclusion: The findings have implications for encouraging the use of appropriate WCB for those attempting to control weight, especially in women., (Copyright © 2018. Published by Elsevier Ltd.)

Abstract Introduction Overweight and obesity are common problems among teenagers regardless of ethnicity, race, and socio-economic status. Therefore, this study aims to explore the social and environmental factors impacting adolescents motivation for weight control in Gilan province, Iran. Methodology Following a qualitative design, a content analysis approach was used to analyze the data. A total of 79 interviews were conducted with Adolescents (n = 23), Friends and Peers (n = 15), Parents (n = 12), Managers (n = 16), and Health care providers (n = 13), regarding adolescents obesity during 2019. MAXQDA V.10 software was used for our analysis. Findings The main categories of environmental and social factors affecting adolescents motivation for weight control were external factors (the relative success of weight control intervention programs, the lack of environmental and social support, and the lack of family support for teenagers) that each one had some subcategories, and internal factors (competence, relatedness, and autonomy). Conclusion This study demonstrated the necessity of identifying environmental and social factors that are effective in reducing adolescents’ motivation for weight loss. These factors are so influential that teenagers can’t overcome them without receiving support from their environment and the government health-related policies. So, it seems that we need integrated multisectoral approaches and we suggest that health policymakers develop practical policies to control adolescents obesity by focusing on factors that have been mentioned in this study.

Background: Over the past decades, the prevalence of obesity has markedly increased worldwide. Stress is recognized as a substantial contributor to increased body weight; therefore, stress management interventions, especially cognitive behavioural, are becoming increasingly popular. The impact of stress management on stress- and obesity-related biomarkers (eg blood lipid profile, HBA1c, inflammatory biomarkers, such as CRP) has been scarcely studied. The aim of this study was to assess the effect of a novel cognitive behavioural stress management intervention, called 'Pythagorean Self-Awareness Intervention' (PSAI), in overweight/obese adults., Materials and Methods: This was a two-armed 1:1 randomized, nonblind controlled study including overweight/obese individuals. The control group followed a personalized Mediterranean low-calorie diet, and the intervention group followed the same diet in addition to the PSAI intervention for 8 weeks. Measurements included demographic, anthropometric (ie BMI, waist-to-hip ratio), stress (ie perceived stress, salivary cortisol), dietary behaviour (ie emotional eating) and metabolic parameters (ie blood lipid profile, HBA1c, CRP, body composition in fat and water). Outcome per-protocol analysis was performed using mixed linear models adjusted for age and gender., Results: A total of 49 of 62 eligible adults were analysed in the study (there were three dropouts in the intervention group and 10 dropouts in the control group); 28 were assigned to the intervention group (mean age 54.7 ± 11.9 years) and 21 to the control group (mean age 51.8 ± 11.9 years). The intervention group showed a statistically significant decrease in perceived stress, cortisol concentrations 30 minutes after awakening, cortisol's area under the curve, BMI, waist-to-hip ratio, restrained, emotional and external eating behaviour, fasting glucose, LDL, triglycerides, HbA1c and body and trunk fat, compared with the control group. Based on the observed effect sizes, clinically meaningful changes may be more evident in stress perception, restrained and external eating behaviour, Hb1ac and trunk fat. The compliance to the PSAI intervention reached 100%, and there were no adverse effects., Conclusions: The PSAI technique may be an effective stress management method for overweight/obese adults. Future and larger randomized controlled studies are needed to allow generalization of these findings., (© 2019 Stichting European Society for Clinical Investigation Journal Foundation.)

Objective: to compare the effects of the hydroalcoholic extract from the peel of Camu-Camu, a fruit plant belonging to the Myrtaceae family, widely distributed in the Amazon basin, with those of sleeve gastrectomy, on the weight and glycemia of Wistar rats., Methods: twenty-four Wistar rats underwent obesity induction through a hyperlipid diet for eight weeks (fat period), and were randomized into three groups: Control Group (CG), Camu-Camu Group (CCG) and Bariatric Surgery Group (BSG). After this period, all animals returned to a normal diet and the intervention period began: CG did not undergo any intervention beyond diet change; CCG animals underwent gavage procedure for administration of Camu-Camu hydroalcoholic extract, 1g/kg/day, for four weeks; and the BSG was submitted to the surgical procedure of sleeve gastrectomy. We followed all animals for four weeks., Results: there was only one loss in BSG due to a gastric fistula. We observed significant variations in the animals' mean weight: the CG evolved with weight gain even after the withdraw of the hypercaloric diet, while the other two groups presented weight reduction. BSG presented a significant reduction of weight and BMI (p<0.05); CCG achieved a significant reduction only of the BMI (p<0.05). There were no statistically significant changes in the glycemic levels., Conclusion: in spite of reducing weight, the crude hydroalcoholic extract of the Camu-Camu peel was not able to be as efficient as sleeve gastrectomy in the control of body weight in Wistar rats.

Background: Breast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women., Methods: Overweight or obese (n = 243) and normal weight (n = 166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes., Results: Forty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight -2.3 (-3.5, -1.0) kg, body fat -1.6 (-2.6, -0.7) kg, community vs. control; weight -2.4 (-3.6, -1.1) kg, body fat -1.4 (-2.4, -0.5) kg (all p < 0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective., Conclusions: The programmes were equally effective for weight control, but the community programme had additional benefits., Clinical Trial Registration: ISRCTN68576140.